Monster
Ahuana, Architect of Ceremonies

Room	Flavour
Flavour	"When the Vaal discovered power could be gained from sacrificing the living, Atzoatl became a death march for the lower classes." - Icius Perandus, Antiquities Collection, Obsidian Sacrificial Knife
AlvaTempleFeature_SacrificeRoomIII	So many dead... Let's please not end up like that.
Incursion_SacrificeRoom3	The blood of Ahuana's sacrifices is on your hands, Exile. And now there will be a lot of them.

Offer	Your Offer	Note
Mask of the Stitched Demon	1x Mask of the Spirit Drinker 1x Vial of Summoning
Coward's Legacy	1x Coward's Chains 1x Vial of Consequence
Fate of the Vaal	1x Story of the Vaal 1x Vial of Fate
Zerphi's Heart	1x Sacrificial Heart 1x Vial of Sacrifice
Omeyocan	1x Dance of the Offered 1x Vial of the Ritual
Apep's Supremacy	1x Apep's Slumber 1x Vial of Awakening
Soul Ripper	1x Soul Catcher 1x Vial of the Ghost
Slavedriver's Hand	1x Architect's Hand 1x Vial of Dominance
Transcendent Flesh	1x Tempered Flesh 1x Vial of Transcendence
Transcendent Spirit	1x Tempered Spirit 1x Vial of Transcendence
Transcendent Mind	1x Tempered Mind 1x Vial of Transcendence

Edit

Apex of Ascension

Apex of Ascension is one of the level 3 incursion rooms of the Temple of Atzoatl that can be obtained by upgrading the Hall of Offerings during temporal incursion.

The room contains an Altar of Sacrifice which provides the player with one of two different functions:

Sacrifice a unique item for another random unique item of the same item class, including items not ordinarily obtainable.
Transforms unique items found exclusively in the Temple of Atzoatl.

The altar may only be used once per temple.

Sacrifice a unique item for another unique item

League mechanics: Incursion. While in an incursion, the player can open passages and kill architects to change or upgrade the room, which affects the Temple's layout in the future. After 11 incursions, the Temple in present time can be raided for loot and special altars which modify items.

Crafting Bench	Tier	Incursion room	Sacrifice
Table of Sacrifice	Tier 1	Sacrificial Chamber	Allows you to sacrifice a unique item. Ahuana drops an additional random Unique Item.
Table of Sacrifice	Tier 2	Hall of Offerings	Sacrifice a unique item for another random unique item. The same item class unique can be obtained.
Altar of Sacrifice	Tier 3	Apex of Ascension	Change a unique item into another. You will gain a unique item of the same item class as the one sacrificed. Transforms unique items found exclusively in the Temple of Atzoatl.

PoE 3.20: Ancient Orbs and the Altar of Sacrifice in the Temple of Atzoatl can no longer be used on Unique Jewels, Flasks or Maps.

Vials are currency items used to upgrade certain unique items to their more powerful versions. They are used by placing one in the Altar of Sacrifice in Apex of Ascension (a level 3 room that upgraded from Sacrificial Chamber and Hall of Offerings) along with the required unique item. Vials can only be obtained from The Vaal Omnitect.

Vial	Original item	Upgraded item
Vial of Awakening	Apep's Slumber	Apep's Supremacy
Vial of Consequence	Coward's Chains	Coward's Legacy
Vial of Dominance	Architect's Hand	Slavedriver's Hand
Vial of Fate	Story of the Vaal	Fate of the Vaal
Vial of Summoning	Mask of the Spirit Drinker	Mask of the Stitched Demon
Vial of the Ritual	Dance of the Offered	Omeyocan
Vial of Transcendence	Tempered Flesh	Transcendent Flesh
Vial of Transcendence	Tempered Spirit	Transcendent Spirit
Vial of Transcendence	Tempered Mind	Transcendent Mind
Vial of Sacrifice	Sacrificial Heart	Zerphi's Heart
Vial of the Ghost	Soul Catcher	Soul Ripper